Vance’s Anti-Fraud Taskforce Makes Major Move On Medicare Fraud
The Trump governance is reportedly pausing Medicare enrollment for new home health and hospice providers, as part of Vice President JD Vance’s anti-fraud efforts. The Centers for Medicare and Medicaid Services (CMS) says the pause is intended to stop improper billing and keep suspected bad actors from entering the Medicare system. CMS Administrator Dr. Mehmet Oz cited “systemic and deeply troubling fraud” that targets vulnerable patients, and said the agency will intensify investigations, use advanced analytics, and remove providers suspected of fraud during the six-month moratorium.
CMS also notes that the Medicare Fee-for-Service improper payment rate was estimated at 6.55% for fiscal year 2025,down from 7.66% in fiscal year 2024. The article additionally references recent DOJ actions against Medicare fraud, including the sentencing of former NFL player joel Rufus French to more than 16 years for a $197 million scheme, and a federal order to seize over $2 million from an advanced wound care clinic alleged to have billed for procedures that were not performed.
The Trump administration is temporarily pausing new home health and hospice providers from enrolling in Medicare, Reuters first reported Wednesday.
The move is part of Vice President JD Vance’s anti-fraud task force’s broader efforts to eliminate healthcare fraud across the U.S., according to Reuters. Centers for Medicare and Medicaid Services (CMS) said in a statement that the agency is continuing the administration’s “crackdown on fraud, waste, and abuse in the Medicare program by stopping improper billing and preventing bad actors from entering the system.”
“We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer,” CMS Administrator Dr. Mehmet Oz said in a statement. “Today we’re shutting the door on fraud — preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them.”
During the six-month moratorium, CMS plans to “intensify targeted investigations, deploy advanced data analytics, and accelerate the removal of hospice and HHA providers from the Medicare program that are suspected of committing fraud,” according to the agency’s news release from Wednesday.
Vance claimed in a Tuesday statement posted to X that the administration is “unleashing the most aggressive federal anti-fraud efforts in American history.”
In fiscal year 2025, the Medicare Fee-for-Service estimated improper payment rate was 6.55%, compared to the reported rate of 7.66% in fiscal year 2024, according to CMS estimates released in January.
The Department of Justice (DOJ) announced on May 8 that former NFL player Joel Rufus French was sentenced to over 16 years in prison for his role in a yearslong $197 million Medicare fraud scheme. Additionally, a federal court granted the U.S. request in April to seize over $2 million from an advanced wound care clinic based in Pasadena, Calif. which was accused of defrauding Medicare for reimbursements for skin graft substitutes and skin grafts that were never performed on patients, according to the DOJ.
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